Syphilis
Symptoms, Diagnosis, and Treatment
🦠 What is Syphilis?
Syphilis is a complex and stealthy sexually transmitted infection (STI) caused by the bacterium Treponema pallidum. This infection can develop silently, without noticeable symptoms in the early stages. If left undiagnosed and untreated, it can lead to severe multi-system complications, affecting the nervous, cardiovascular, and visual systems.
📜 Historical Overview
Syphilis was first recognized in Europe in the late 15th century, quickly becoming one of the greatest public health challenges of its time. Medical and societal perceptions of the disease changed dramatically with the discovery of penicillin in the 1940s, which introduced a revolutionary treatment that remains effective to this day.
📈 Modern Spread
Despite the availability of effective treatment, syphilis continues to spread, particularly in urban areas and regions with limited access to preventive healthcare. In recent years, cases have been increasing, especially among individuals with multiple sexual partners and those who do not undergo regular STI screenings.
💡 Why is it Important to Be Aware of Syphilis?
✔️ It may remain asymptomatic for a long time.
✔️ If left untreated, it can cause serious long-term complications.
✔️ Early diagnosis and treatment are simple and can prevent severe health issues.
⚠️ If you have any concerns, schedule a test. Prevention is the best cure!
📊 Syphilis Statistics
📢 Syphilis remains a global public health threat, with a concerning rise in cases over the past years. Data highlights that early diagnosis and treatment are crucial in preventing severe complications.
🌍 Global Statistics (WHO)
🔹 7+ million new syphilis cases are reported annually.
🔹 Congenital syphilis (transmission from mother to fetus) has increased dramatically, posing a serious risk to newborns.
🔹 In parts of Europe and North America, syphilis rates have risen by 50% in the past decade.
🔹 40% of untreated individuals develop severe complications, such as neurological disorders and blindness.
📈 Who is Most at Risk?
✔️ Individuals with multiple sexual partners.
✔️ Those who do not use protection during sexual activity.
✔️ People who do not undergo regular STI screenings.
🩺 Symptoms of Syphilis
Syphilis progresses through four distinct stages, each with different symptoms and risks. While early signs may disappear on their own, the infection remains active in the body and can cause severe complications if left untreated.
1️⃣ Primary Syphilis
📌 Symptoms:
✔️ Painless, hard sores (called chancres) appear on the genitals, anus, or mouth.
✔️ These sores heal on their own within a few weeks, but the bacteria remain active in the body.
✔️ Possible swelling of lymph nodes near the infection site.
💡 🚨 Common mistake: Many people ignore the first sore since it doesn’t cause pain and disappears naturally, allowing the infection to progress unnoticed.
2️⃣ Secondary Syphilis
📌 Symptoms:
✔️ Distinctive rashes on the palms of the hands and soles of the feet (usually non-itchy).
✔️ Flu-like symptoms: Fever, fatigue, muscle aches, headache, and sore throat.
✔️ Possible hair loss and discolored lesions in the mouth and genital area.
💡 ⚠️ Be aware: In this stage, symptoms can be mild and mistaken for a common cold or allergy.
3️⃣ Latent Syphilis
📌 What happens in this stage?
🔸 The bacteria remain dormant in the body without visible symptoms.
🔸 Although the person shows no signs of illness, syphilis can still be transmitted.
🔸 This stage can last for months or even years.
💡 🚨 Warning: Many people assume they are cured because their symptoms disappear, but the infection remains active in the body.
4️⃣ Tertiary Syphilis
📌 Complications:
❗ Progressive paralysis and loss of sensation.
❗ Damage to the brain, heart, and blood vessels.
❗ Irreversible neurological disorders and blindness.
💡 ⚠️ This is the most dangerous stage: It can develop 10–30 years after the initial infection and is potentially fatal if left untreated.
✅ 🔍 When Should You Get Tested for Syphilis?
🩺 If you notice any of the above symptoms, even if they have disappeared.
🩺 If you have had unprotected sex or a new sexual partner.
🩺 If you belong to a high-risk group (multiple partners, history of STIs).
🩺 Syphilis Diagnosis
Syphilis can be easily diagnosed through specialized laboratory tests, even if no visible symptoms are present. Early diagnosis is crucial for effective treatment and the prevention of severe complications.
🧪 How is Syphilis Diagnosed?
✅ Blood Tests
📌 Detects specific and non-specific antibodies that the body produces against Treponema pallidum.
📌 Includes tests such as VDRL, RPR, TPHA, and FTA-ABS, depending on the stage of the infection.
✅ Dark-Field Microscopy
📌 Used for direct detection of the bacteria in fluid from primary sores or lesions.
📌 Especially useful in early stages, before antibodies develop.
✅ Neurological Tests (if neurosyphilis is suspected)
📌 Performed when the infection affects the central nervous system.
📌 May include:
-
Lumbar puncture (spinal tap) to analyze cerebrospinal fluid.
-
Imaging tests (MRI, CT scan) to detect possible brain lesions.
💡 When Should You Get Tested for Syphilis?
🔹 If you have sores, rashes, or flu-like symptoms with no obvious cause.
🔹 If you have had unprotected sex or a new sexual partner.
🔹 If you are pregnant, as syphilis can be transmitted to the baby.
🔹 If you have been diagnosed with another STI, as co-infections are common.
⚠️ Syphilis often does not cause immediate symptoms, making regular screening essential!
🔬 How is Syphilis Transmitted?
Syphilis is highly contagious and can be spread in multiple ways, even if there are no visible symptoms.
🦠 Modes of Transmission:
✅ Sexual Contact
📌 Syphilis is transmitted through vaginal, anal, or oral sex with an infected person.
📌 Condoms reduce the risk, but do not completely eliminate it, as syphilis can spread through skin-to-skin contact with sores that are not covered.
✅ Direct Contact with Open Sores
📌 The Treponema pallidum bacterium enters the body through tiny cuts or mucous membranes.
📌 Even if syphilis sores are painless, they are highly infectious.
✅ Mother-to-Fetus Transmission (Congenital Syphilis)
📌 A pregnant woman with syphilis can pass the infection to her baby through the placenta.
📌 Congenital syphilis can cause severe complications or even stillbirth if not diagnosed and treated in time.
⚠️ Myths & Facts
❌ Syphilis is NOT spread through shared objects like toilets, eating utensils, or hugging.
✔️ Syphilis IS transmitted only through direct contact with infectious sores or sexual activity.
💡 🔍 How Can You Protect Yourself?
✔️ Use condoms during every sexual encounter.
✔️ Get regular STI screenings, especially if you have new or multiple partners.
✔️ Pregnant? Get a prenatal syphilis test to protect your baby.
⚠️ Prevention and early testing are key! If in doubt, schedule a screening today.
💊 Syphilis Treatment
Syphilis is fully curable if diagnosed early! The treatment varies depending on the stage of infection, but the first-line antibiotic remains Penicillin G.
✅ Penicillin G – The Most Effective Treatment
🔹 Administered intramuscularly, with dosage depending on the stage of the disease.
🔹 A single dose is sufficient for early stages, while multiple doses are required for advanced cases.
✅ Alternative Treatments (for those allergic to penicillin)
🔹 Doxycycline (oral treatment for 14–28 days, depending on the stage).
🔹 Azithromycin (used with caution due to reports of resistant strains).
🔹 Ceftriaxone (injectable alternative for advanced syphilis).
⚠️ Important Considerations!
❗ Treatment cannot reverse existing damage caused by late-stage syphilis (e.g., neurological complications).
❗ Regular follow-ups and repeat testing are essential after treatment to ensure the infection is fully cleared.
🛑 Syphilis Prevention
The best way to fight syphilis is prevention! By following simple but effective practices, you can reduce the risk of infection.
✅ Use Protection 🛡️
📌 Condoms significantly reduce the risk of transmission.
📌 However, they do not provide complete protection, as syphilis can spread through skin contact with infected areas.
✅ Regular Screening 🏥
📌 Recommended especially for high-risk individuals (multiple partners, history of STIs, unprotected sex).
📌 Blood tests are simple, painless, and life-saving!
✅ Awareness & Sexual Health 📢
📌 Early diagnosis and treatment prevent the spread of syphilis.
📌 If diagnosed, it is important to inform sexual partners so they can get tested and treated if necessary.
⚠️ Myth vs. Fact
❌ Myth: "If I have no symptoms, I don’t need a test."
✔️ Fact: Syphilis can remain symptomless for months or even years while still being contagious.
Θεραπεία των Πέτρων στα Νεφρά (Νεφρολιθίαση)
Η θεραπεία για τις πέτρες στα νεφρά εξαρτάται από το μέγεθος, τη θέση, τη χημική σύσταση της πέτρας, τα συμπτώματα του ασθενούς και τυχόν επιπλοκές που έχουν προκύψει. Στόχος της θεραπείας είναι η απομάκρυνση της πέτρας, η ανακούφιση των συμπτωμάτων και η πρόληψη υποτροπών.
1. Συντηρητική Θεραπεία
Αναμονή και Αυθόρμητη Αποβολή
- Μικρές πέτρες (διάμετρος έως 5-6 χιλιοστά) συχνά αποβάλλονται μόνες τους μέσω των ούρων.
- Συνιστάται:
- Αυξημένη κατανάλωση υγρών για την προώθηση της πέτρας μέσω του ουροποιητικού.
- Αναλγητικά φάρμακα (π.χ. ιβουπροφαίνη) για την ανακούφιση του πόνου.
- Φάρμακα για τη χαλάρωση του ουρητήρα (π.χ. α-αδρενεργικοί ανταγωνιστές) για τη διευκόλυνση της αποβολής.
Διατροφική Αλλαγή και Φαρμακευτική Θεραπεία
- Εξατομικευμένη δίαιτα με περιορισμό τροφών που συμβάλλουν στο σχηματισμό λίθων, όπως οξαλικά (σπανάκι, παντζάρια), ζωικές πρωτεΐνες και αλάτι.
- Φαρμακευτική αγωγή για τη μείωση της δημιουργίας λίθων, ανάλογα με τη χημική σύστασή τους:
- Διουρητικά θειαζιδικά για λίθους ασβεστίου.
- Αλλοπουρινόλη για λίθους ουρικού οξέος.
- Κιτρικά άλατα για την αύξηση των επιπέδων κιτρικών στα ούρα.
2. Επεμβατικές Θεραπείες
Όταν οι πέτρες δεν αποβάλλονται φυσικά ή προκαλούν σοβαρά συμπτώματα ή επιπλοκές, μπορεί να απαιτηθεί επεμβατική αντιμετώπιση:
Λιθοτριψία με Κρουστικά Κύματα (ESWL)
- Μη επεμβατική μέθοδος που χρησιμοποιεί κρουστικά κύματα για τη διάσπαση της πέτρας σε μικρότερα κομμάτια, τα οποία αποβάλλονται μέσω των ούρων.
- Ιδανική για πέτρες μικρού ή μεσαίου μεγέθους.
- Μπορεί να προκαλέσει παροδικό πόνο ή αιματουρία.
Ενδοσκοπική Λιθοτριψία (URS)
- Μέσω ενός λεπτού ενδοσκοπίου, η πέτρα εντοπίζεται και αφαιρείται ή διασπάται με laser.
- Ιδανική για πέτρες στον ουρητήρα ή στην ουροδόχο κύστη.
Διαδερμική Νεφρολιθοτριψία (PCNL)
- Χρησιμοποιείται για μεγάλες ή πολύπλοκες πέτρες στους νεφρούς.
- Πραγματοποιείται μέσω μικρής τομής στο δέρμα, με τη χρήση ειδικών εργαλείων για τη διάσπαση και αφαίρεση της πέτρας.
Λαπαροσκοπική Χειρουργική
- Σπάνια απαιτείται και συνήθως επιλέγεται σε περιπτώσεις πολύ μεγάλων λίθων ή ανατομικών ανωμαλιών του ουροποιητικού συστήματος.
3. Θεραπεία Επιπλοκών
- Τοποθέτηση ουρητηρικού καθετήρα (Pig-tail) για την ανακούφιση της απόφραξης.
- Αντιβιοτική αγωγή σε περίπτωση λοίμωξης του ουροποιητικού συστήματος.
4. Πρόληψη Υποτροπών
Μετά την απομάκρυνση της πέτρας, είναι σημαντικό να υιοθετηθούν μέτρα πρόληψης:
- Αυξημένη κατανάλωση νερού για τη διατήρηση αραιών ούρων.
- Διατροφικές τροποποιήσεις με τη βοήθεια διαιτολόγου ή ειδικού.
- Τακτική παρακολούθηση με απεικονιστικές και εργαστηριακές εξετάσεις για την έγκαιρη ανίχνευση νέων λίθων.
Η σωστή θεραπεία της νεφρολιθίασης εξαρτάται από την έγκαιρη διάγνωση και την εξατομικευμένη προσέγγιση, ώστε να επιτευχθεί η μέγιστη ανακούφιση και πρόληψη των υποτροπών.